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Black-White disparities in colorectal cancer outcomes: a simulation study of screening benefit.

Authors :
Rutter CM
Nascimento de Lima P
Maerzluft CE
May FP
Murphy CC
Source :
Journal of the National Cancer Institute. Monographs [J Natl Cancer Inst Monogr] 2023 Nov 08; Vol. 2023 (62), pp. 196-203.
Publication Year :
2023

Abstract

The US Black population has higher colorectal cancer (CRC) incidence rates and worse CRC survival than the US White population, as well as historically lower rates of CRC screening. The Surveillance, Epidemiology, and End Results incidence rate data in people diagnosed between the ages of 20 and 45 years, before routine CRC screening is recommended, were analyzed to estimate temporal changes in CRC risk in Black and White populations. There was a rapid rise in rectal and distal colon cancer incidence in the White population but not the Black population, and little change in proximal colon cancer incidence for both groups. In 2014-2018, CRC incidence per 100 000 was 17.5 (95% confidence interval [CI] = 15.3 to 19.9) among Black individuals aged 40-44 years and 16.6 (95% CI = 15.6 to 17.6) among White individuals aged 40-44 years; 42.3% of CRCs diagnosed in Black patients were proximal colon cancer, and 41.1% of CRCs diagnosed in White patients were rectal cancer. Analyses used a race-specific microsimulation model to project screening benefits, based on life-years gained and lifetime reduction in CRC incidence, assuming these Black-White differences in CRC risk and location. The projected benefits of screening (via either colonoscopy or fecal immunochemical testing) were greater in the Black population, suggesting that observed Black-White differences in CRC incidence are not driven by differences in risk. Projected screening benefits were sensitive to survival assumptions made for Black populations. Building racial disparities in survival into the model reduced projected screening benefits, which can bias policy decisions.<br /> (© The Author(s) 2023. Published by Oxford University Press. All rights reserved. For permissions, please email: journals.permissions@oup.com.)

Details

Language :
English
ISSN :
1745-6614
Volume :
2023
Issue :
62
Database :
MEDLINE
Journal :
Journal of the National Cancer Institute. Monographs
Publication Type :
Academic Journal
Accession number :
37947338
Full Text :
https://doi.org/10.1093/jncimonographs/lgad019